What is the impact of CYP7B1 on the prognosis of endometrial cancer: a cohort study

Abstract

Abstract Background: Endometrial cancer (EC) tissues express CYP7B1, but its association with prognosis needs to be investigated. Methods: Immunohistochemistry and image analysis software were used to assess CYP7B1 protein expression in 307 paraffin-embedded endometrial tumor sections. Associations between CYP7B1 and clinical factors were tested with the Wilcoxon rank-sum test. Cox regression analysis was used to assess the association between CYP7B1 expression and the prognosis of patients with EC. Kaplan-Meier curves were employed to describe survival, and differences were assessed using the log-rank test. Results: A total of 307 patients were ultimately enrolled with an average age of 52.6±8.0 years at diagnosis. During follow-up, 46 patients (15.0%) died, and 29 (9.4%) suffered recurrence. The expression of CYP7B1 protein was significantly greater in the cytoplasm than in the nucleus. Higher levels of CYP7B1 protein were observed in patients aged <55 years, in ER-positive patients and in PR-positive patients. Both univariate (HR=0.41, 95% CI: 0.18-0.90) and multivariate (HR=0.35, 95%CI:0.16-0.79) Cox regression analyses demonstrated that high CYP7B1 protein expression predicted longer overall survival (OS). When considering only ER-positive patients, CYP7B1 protein expression was more strongly associated with OS (HR=0.20,95%CI:0.08-0.52). The 3-year OS and 5-year OS in the low-CYP7B1 subgroup were 81.6% and 76.8%, respectively; while in the high-CYP7B1 subgroup were 93.0% and 92.0%, respectively (P=0.021). Conclusions: High CYP7B1 protein expression predicted longer OS, suggesting that it may serve as an important molecular marker for predicting EC prognosis.